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Individual

AMY PENAL SHALEEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
11725 STINSON AVE, CHISAGO CITY, MN 55013-9542
(651) 257-7806
(651) 257-8852
Mailing address
11725 STINSON AVE, CHISAGO CITY, MN 55013-9542
(651) 257-7806
(651) 257-8852

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16482
MN

Other

Enumeration date
08/11/2016
Last updated
08/11/2016
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